Risk Factors, Pathogens, and Outcomes of Ventilator-Associated Pneumonia in Non-Cardiac Surgical Patients: A Retrospective Analysis.

Autor:	Chang PH; Department of Pharmacy, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, Taiwan.; Chang Gung University College of Medicine, Kaohsiung 833, Taiwan., Lin TL; Chang Gung University College of Medicine, Kaohsiung 833, Taiwan.; Department of Surgery, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, Taiwan., Chen YJ; Chang Gung University College of Medicine, Kaohsiung 833, Taiwan.; Department of Surgery, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, Taiwan., Lai WH; Chang Gung University College of Medicine, Kaohsiung 833, Taiwan.; Department of Surgery, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, Taiwan., Chen IL; Department of Pharmacy, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, Taiwan.; Chang Gung University College of Medicine, Kaohsiung 833, Taiwan.; School of Pharmacy, Kaohsiung Medical University, Kaohsiung 807, Taiwan., Chang HC; Chang Gung University College of Medicine, Kaohsiung 833, Taiwan.; Department of Respiratory Therapy, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, Taiwan., Lin YC; Chang Gung University College of Medicine, Kaohsiung 833, Taiwan.; Department of Surgery, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, Taiwan., Lin YH; Chang Gung University College of Medicine, Kaohsiung 833, Taiwan.; Department of Surgery, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, Taiwan., Li WF; Chang Gung University College of Medicine, Kaohsiung 833, Taiwan.; Department of Surgery, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, Taiwan., Liu YW; Chang Gung University College of Medicine, Kaohsiung 833, Taiwan.; Department of Surgery, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, Taiwan., Wang CC; Chang Gung University College of Medicine, Kaohsiung 833, Taiwan.; Department of Surgery, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, Taiwan., Liu SF; Chang Gung University College of Medicine, Kaohsiung 833, Taiwan.; Department of Respiratory Therapy, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, Taiwan.; Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, Taiwan.
Jazyk:	angličtina
Zdroj:	Microorganisms [Microorganisms] 2024 Jul 13; Vol. 12 (7). Date of Electronic Publication: 2024 Jul 13.
DOI:	10.3390/microorganisms12071422
Abstrakt:	Ventilator-associated pneumonia (VAP) is a critical hospital-acquired infection following non-cardiac surgeries, leading to poor outcomes. This study identifies VAP risk factors in non-cardiac surgical patients and determines the causative pathogens. A retrospective analysis with 1:4 propensity-score matching was conducted on patients in a surgical intensive care unit (ICU) from 2010 to 2020 at a private tertiary medical center. Among 99 VAP patients, the mortality rate was 64.7%. VAP risk factors included prolonged mechanical ventilation (odds ratio [OR] 6.435; p < 0.001), repeat intubation (OR 6.438; p < 0.001), lower oxygenation levels upon ICU admission (OR 0.950; p < 0.001), and undergoing gastrointestinal surgery (OR 2.257; p = 0.021). The 30-day mortality risk factors in the VAP group were late-onset VAP (OR 3.450; p = 0.022), inappropriate antibiotic treatment (OR 4.083; p = 0.041), and undergoing gastrointestinal surgeries (OR 4.776; p = 0.019). Nearly half of the Gram-negative infections were resistant strains, and a third were polymicrobial infections. Non-cardiac surgical patients with VAP face adverse hospital outcomes. Identifying high-risk patients and understanding VAP's resistant and microbial nature are crucial for appropriate treatment and improved health outcomes.
Databáze:	MEDLINE
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